State and trait anxiety modulate hemodynamic amygdala responses to innocuous auditory stimulation

Anxiety strongly influences emotion processing and the perception of threat. Amygdala activity has been consistently linked to the evaluation of affective salience and threatening stimuli. Here, we investigated whether state and trait anxiety modulate amygdala responses to fearful and neutral stimuli, and whether such modulation differs across visual and auditory modalities. Healthy participants (N = 36, 50% female) underwent functional magnetic resonance imaging (fMRI) while being presented with fearful and neutral faces and voices. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI). Whole-brain and amygdala responses were analysed in relation to individual anxiety scores. Higher state and trait anxiety scores were associated with stronger right amygdala responses to neutral relative to fearful voices. This anxiety-related modulation was specific to the auditory modality and was not observed for visual stimuli, despite the participants’ similar emotion ratings across neutral voices and faces. Together, these findings suggest that anxiety is associated with enhanced amygdala sensitivity to emotionally neutral auditory signals, consistent with heightened vigilance to innocuous or ambiguous cues.